EP0151066A2 - Apparatus for training, investigation and re-education, particularly of the neuro-muscular function - Google Patents

Abstract

The exercise apparatus includes a motor-reduction gear unit (10, 11) controlling an input shaft (20), and mounted on a frame (1). A drum (50) receives a cable (5) at the end of which there is placed a detector (155) and then a handle (56). Between the shaft (20) and the drum (50) there are mounted in parallel firstly a freewheel transmission (36) and, secondly an electromagnetic powder clutch (35). Various pre-adjusted control values for exciting the clutch (35) enable accurate adjustment of the apparatus, in particular for exercises of the "servo-controlled work", "static work", or "direct work" types, to be accompanied by "rest" phases.

Description

The invention relates to an exercise device intended in particular for rehabilitation, training and investigation of neuro-muscular function.

We already know devices tending to achieve a control of the resistance it offers to an effort produced by a patient. However, until now, the various known devices have only been able to approach the needs encountered in sports training or in physiotherapy, also called physiotherapy, in an insufficient manner.

The present invention provides an improved exercise machine.

In known manner, the apparatus of the invention comprises a fixed frame, a working member intended to be connected to the subject to be exercised, a driving member, a transmission device mounted between the driving member and the working member, and means for adjusting, controlling and quantifying the force and / or the displacement of the working member as a function of determined parameters.

According to a general characteristic of the invention, this transmission device comprises, mounted in parallel between the driving member and the working member, on the one hand a force coupler whose transmitted torque is adjustable, and on the other hand share a one-way drive means, which connects the working member to the motor member when the ratio of their speeds in absolute value exceeds a predetermined threshold.

• - les figures lA, 1B et 1C sont respectivement des vues de face, de gauche et de droite d'un mode de réalisation de la partie mécanique de l'appareil selon l'invention, sans capot;
• - la figure 2 illustre schématiquement la constitution générale de l'appareil selon l'invention dans un mode de réalisation préférentiel; et
• - la figure 3 illustre schématiquement la partie électronique de l'appareil dans un même mode de réalisation préférentiel.

Other characteristics and advantages of the invention will appear on examining the detailed description which follows, and the appended drawings, in which:

• - Figures lA, 1B and 1C are respectively front views, left and right of an embodiment of the mechanical part of the device according to the invention, without cover;
• - Figure 2 schematically illustrates the general constitution of the apparatus according to the invention in a preferred embodiment; and
• - Figure 3 schematically illustrates the electronic part of the device in the same preferred embodiment.

In FIGS. 1A to 1C, a frame 1 supports a motor 10, the output shaft of which is connected to a reduction gear. 11 irreversible.

The motor and the gearbox are for example the MELY-CLERELY 0/3000 rpm 400 watts models.

The output shaft 20 of the reduction gear 11 is supported at its other end by a bearing 12. In the intermediate part, it is provided with a notched crown of fairly large diameter 21. At its other end, it is provided with a second notched crown of smaller diameter 30.

Another bearing 18, integral with the frame, supports a shaft 4 on which is mounted a notched crown 23 of small diameter. This crown 23 is connected to the large crown 21 by a first transmission chain 22.

A rope-holding drum 50 is mounted rotating on the shaft 4.

The rope 5 comes out between two rope guide shafts 51 and 52, to come to its free end to form a loop 55 on which is mounted for example a handle 56, as regards the musculature of the arms. Any other suitable means of gripping and / or fixing will be used for other parts of the body, such as the legs.

The right flange of the drum 50 is integral with the outer ring of an electromagnetic powder clutch 35. This clutch is for example of the MEROBEL EAT 120 type.

The internal crown 35bis of the clutch 35 is mounted integral with the shaft 4.

The so-called "eccentric" chain of motion, made up of the elements 10, 11, 21, 22, 23, 4, 35bis, transmits its angular speed N ₂ to the rope-holding drum 50 when the inductor winding of the clutch 35 is put under pressure. This chain therefore tends to wind the rope on the drum and to drive the patient's arm by the handle 56; if the operator resists too strongly, the clutch "slips", and there is relative movement between the crowns 35 and 35bis, but with transmission of a calibrated force on the rope in the direction of rewinding. The tared force depends on the adjustment of the intensity of the excitation current which flows through the clutch inductor 35.

The outer ring of the 1 "clutch 35 is also connected to a latching system 36 (or freewheel), which receives its movement from a notched ring 33.

As best shown in FIG. 1B, the notched crown 33 is driven in the opposite direction to the movement imparted to the shaft 4 by the chain 22. This drive in the opposite direction is obtained by a second chain 32, which is wound on the notched crown 30 already mentioned, on two return crowns 34 and 35, to finally come to drive the crown 33 upside down.

We denote by N ₁ the speed of rotation of the shaft 20; N ₂ the speed printed by the belt 22 to the shaft 4 in a first direction, and N ₃ the lower speed that the belt 32 can print to the drum in the opposite direction, that is to say in the direction of the needles of a watch. The clockwise direction corresponds to the unwinding of the rope 5 on the drum 50, while the anticlockwise direction corresponds to the winding of the rope 5 from the drum 50. _'

It is already possible to define the general operation of the apparatus of the invention.

The latching 36 does not transmit any force to the external crown 35 and to the drum 50 which is linked to it, as long as the action developed by the patient who pulls on the rope by the handle 56 does not tend to impart to him the same speed direction but greater than the speed imposed on the latching 36 by the so-called "concentric" chain of motion constituted by the elements 10, 11, 20, 30, 32, 33.36.

If the patient tends to pull too quickly, then the snap-fastening 36 tends to drive the chain 33, 32, 30, 20, and it cannot do so, since the reducer 11 is irreversible. There is therefore a "reaction", equal to the action of the patient; this reaction is subject to the patient's effort.

The maximum linear speed of unwinding of the rope is preset, independently of the intensity of the forces exerted by a servo-control which is exerted on the motor and reduction unit 10 and 11, as will be seen below. The resistance to the unwinding of the rope is then directly controlled by the active traction force that the patient develops.

According to another aspect of the invention, it has been observed that, when the rope is unwound at a speed lower than the programmed speed, the unwinding resistance becomes almost zero. To remedy this, it is expected that the minimum effort developed by the subject is controlled by programming a constant rewinding force ô, using the electromagnetic clutch 35 and the drive produced by the chain 32. The patient must then overcome this force ô to unwind the rope, even if this unwinding occurs at a speed lower than the programmed nominal speed. The permanent force thus added, and opposing the unwinding of the rope, is called taring force, whatever the speed below the preset speed where the controlled reaction begins.

With reference to the classic names in physiotherapy and physiotherapy, this function can be called muscular training in the "concentric dynamic slave mode".

The apparatus according to the invention also makes it possible to develop static muscular contractions, as well as eccentric dynamic contractions obtained by the so-called eccentric chain mentioned above. As will be seen below, these three modes of exercise can be linked in a predetermined manner.

The two eccentric drive chains 10, 11, 21, 22, 23, 4, 35bis, and concentric drive 10, 11, 20, 30, 32, 33, 36 have so far a common drive source 10, 11.

In practice, it may be beneficial to provide two independent geared motors, one for each drive chain. The shaft 20 is then split, and its right-hand part being connected to a second geared motor (not shown). It is then possible, by the independence of the speeds of the two drive chains, and of their powers, to obtain better performance.

• 1) l'ensemble bâti fixe + moteur à vitesse réglable + réducteur et dispositif de transmission ainsi qu'une partie de l'électronique de commande décrite ci-après figure 3 sont enfermés dans le bloc A qui est l'élément principal de génération d'action et de réaction, destiné à être relié rigidement à un socle fixe ou à une cage de pouliethérapie. Ce bloc A comporte les différents réglages principaux des conditions de fonctionnement définissant les fonctions à remplir et qui sont placées préférentiellement sous le contrôle du personnel moniteur. Le bloc A est généralement placé à une certaine distance du patient.
• 2) Le bloc B est lié dans l'application décrite d'une part au bloc A par un filin et d'autre part à une poignée elle-même liée au patient opérateur.

FIG. 2 schematically illustrates the main blocks constituting the apparatus which is the subject of this patent:

• 1) the fixed frame assembly + adjustable speed motor + reduction gear and transmission device as well as part of the control electronics described below in Figure 3 are enclosed in block A which is the main generation element d action and reaction, intended to be rigidly connected to a fixed base or to a pulley therapy cage. This block A comprises the various main settings of the operating conditions defining the functions to be performed and which are preferably placed under the control of the monitor staff. Block A is usually placed some distance from the patient.
• 2) The block B is linked in the application described on the one hand to the block A by a rope and on the other hand to a handle itself linked to the patient operator.

It includes the device (s) for effort and / or position detector (s) and the transmitter transmitting without link the signals from this (these) detector (s) to the receiver-iecoder located in the block vs.

3) Block C is the mobile unit, made available to the subject to be trained and specialized personnel monitoring or programming the exercises of one or more subjects.

It includes training cycle programming devices; visualization functions for cycled operations and the magnitudes of the efforts or positions actually developed or achieved; fault or performance reporting and counting systems; the elements producing the output signals intended for recording (for example on plotter x (t) or xy); the elements making it possible to program the duration of the functions in the chosen cycle; operating systems either manual or automatic, programmable in time and / or programmable according to the delivered or rewound length of the wire.

A fixed link by an interconnection cable is established between blocks A and C to convey electrical power and adjustment signals.

We will resume, Figure 3, the detailed description of the electrical or electronic control or adjustment sub-blocks ensuring the control of the operation.

Reference is now made to FIG. 3 (and / or 3bis), illustrating a certain number of sub-blocks of an electrical diagram in principle.

The sub-blocks A are intended to be part of the fixed wall frame of FIG. 2, constituting a working unit A. The block B is a sensor circuit which is physically located between the working unit A and the handle 56 for example held by the patient.

The sub-blocks C are part of a mobile unit made available to the trained subject, as well as to that of the specialized personnel who direct the exercise of one or more patients.

It is the block A which brings together the mechanical elements illustrated in FIGS. 1A, 1B and 1C. On the frame, or on an interposed plate, the assembly being fixed to the wall, an electronic circuit is provided consisting of five separate plates.

The board Al defines the general supply circuit from the sector. It consists of a button with two general commissioning states, capable of cutting the phase and the neutral. This pusher noted 101 is associated with a control lamp 102. Downstream of the switch thus formed is provided a low voltage safety supply with high insulation 105. This supply supplies the various currents in particular at six volts necessary for the electronic circuits. It also feeds by self-excitation a relay 103, capable of cutting the circuit of the general supply by its movable contacts 103A and 103B. The electrical circuit for controlling the relay 103 passes through a manual switch 104 with a push button in a state made available to the patient in the event of difficulties, the patient can therefore at any time interrupt the operation of the device. In addition, it is possible to insert an automatic detector such as a circuit breaker (not shown) in the input of the general circuit at 220 volts 50 Hertz.

On the supply of alternating current at 220 volts, and downstream of the safety devices which have just been described, is connected a block 110 serving for the supply of the mobile unit C, of which it therefore constitutes the first module C1. A set of wires connecting with a ground or earth therefore goes to the mobile unit C from the housing 110.

In a plate A2a again appears the motor 10 and its reduction gear 11. Through a fuse 120, the general alternating supply excites a variator 121, which is connected to the terminals of the control and servo circuit 122 of the motor 10. The excitation of the motor is provided by a block 123, in a manner known per se. Finally, the block J22 includes a potentiometric unit 125, which defines the maximum speed of the motor as a function of the exercise which the patient must perform.

• - 121 variateur électronique 433 MELY-CLERELY,
• - 122 bloc relais avec potentiomètre bobiné,
• - 123 alimentation MELY-CLERELY CC pour excitation moteur.

For the aforementioned motors and reducers, the blocks 121, 122 and 123 have, for example, the following constitution:

• - 121 electronic dimmer 433 MELY-CLERELY,
• - 122 relay block with wire potentiometer,
• - 123 MELY-CLERELY CC power supply for motor excitation.

The potentiometer 125 has a value of 10 KQ In return for unit C, the work unit includes a relay plate C2. We will detail the constitution below. It suffices for the moment to remember that this plate C2 will provide on four wires an indication of current representative of a minimum rewinding force or torque. This information is applied to a current generator 140, which receives the general electrical supply, and controls the powder clutch 35.

For the powder clutch mentioned, which is the EAT 120 model, the current generator is the MEROBEL type 1 model. A potentiometer 145 allows the minimum rewinding torque of the rope to be defined.

We will now examine the pitcher B. It is an autonomous unit provided with a battery 150, which supplies a transmitter circuit 151, operating for example at 27.2 MHz. A sensor 155, which is for example of the strain gauge type, is fixed to a deformable metal plate. This plate can be incorporated into the wire guide rollers 51 and 52, when these support most of the force transmitted by the rope. As a variant, the wafer could be directly incorporated into the cable itself, in the vicinity of its end 55. The variation in resistance generated by the mechanical deformation of the plate or strain strain gage pilot in voltage the modulator 154 of the transmitter 151.

Of course, a multi-channel transmitter can be provided, when several parameters are to be monitored simultaneously and / or sequentially.

The mobile unit C constitutes an autonomous control and monitoring desk allowing an experienced operator to control all the functions or exercises that the patient will undergo and perform, who will be informed by this mobile unit of the effectiveness and respect for scheduled activity A receiver 160 tuned to the same frequency as the transmitter 151 receives the signal therefrom. The receiver 160 is provided with an output level adjustment by a potentiometer 161. It is supplied like the other elements of this box C by the supply 110 already mentioned. The signal supplied by the receiver 160 is applied to a force display circuit, denoted 163. This display circuit can comprise different types of displays, in particular a row of light-emitting diodes producing a chain of light points the length of which varies with the magnitude of the effort developed. A galvanometer can be used as a variant.

The output of this case 163 can be connected to an adapter 165 intended to be in turn connected to a recorder by output lines S1 and S2. The recorder is not shown.

• - fonction asservie ; (dite concentrique)
• - fonction statique ;
• - fonction directe; (dite excentrique)
• - fonction repos.

The most important organ of unit C is a set 170. It comprises, according to a pre-established sequence programmable over time, a series of at least four flip-flops timed each from 0 to 20 seconds by a delay circuit, for example of the RC type. In normal automatic operation, each rocker triggers the next one after the end of its time delay, which automatically produces a repetitive exercise. The cycle is for example:

• - slave function; (called concentric)
• - static function;
• - direct function; (called eccentric)
• - rest function.

This time-programmable sequence can be replaced by a programmable sequence depending on the length of the unwound rope (or the length of rewound rope).

We can for example identify the passage of magnetic inserts incorporated in the cable and passing in front of an exit detector placed inside or outside the device (shafts 51 and 52), to trigger the passage to the following sequence . We can also identify the number of turns made by the drum from a zero position of an encoder or a multi-turn potentiometer driven by the drum 50 (with appropriate gear reduction, if necessary). After a selected number of revolutions, the voltage available across the encoder or potentiometer controls a relay toggling to the functions of the following exercise.

In 171 are illustrated the electroluminescent displays indicating the current function. In 172 are illustrated the adjustment potentiometers which form part of the abovementioned RC circuits, and allowing the adjustment of the duration of activation of each flip-flop, for example from 0 to 20 seconds.

• - premièrement un bouton-poussoir dit de "fonctionnement manuel" qui permet d'activer le cycle affiché,
• - deuxièmement un minuteur à contact de fermeture qui permet d'activer le cycle affiché pour la durée choisie, ce minuteur a une capacité maximale de par exemple 30 minutes réglable; il assure une ouverture des contacts, au terme de la durée préréglée, des boutons-poussoirs illustrés en 173 permettant de court-circuiter ou de conserver les différentes fonctions prévues, à savoir fonction asservie, fonction directe, fonction statique et fonction repos. Cette sélection de fonctions se fait simplement par court- circuit de la ou des bascules correspondant à chaque fois à la temporisation liée à la fonction non désirée.

In 174 is planned:

• - firstly a push button called "manual operation" which activates the displayed cycle,
• - secondly a timer with closing contact which activates the displayed cycle for the chosen duration, this timer has a maximum capacity of, for example, 30 minutes adjustable; it ensures opening of the contacts, at the end of the preset duration, of the pushbuttons illustrated in 173 making it possible to short-circuit or to keep the various planned functions, namely slave function, direct function, static function and rest function. This selection of functions is done simply by short-circuiting the flip-flop (s) corresponding each time to the time delay linked to the unwanted function.

Finally, at the bottom of this device 170, inside the frame 175, four contacts or "states" of which only one is activated at a time during the cycle and which define the current function among the aforementioned four functions (controlled , static, direct, rest).

We then return to box C2. The four contacts or states are transmitted by electrical links 179 going to four relay windings 181 to 184 respectively associated. Each of these relay windings validates contacts allowing the use of a corresponding potentiometer 191 to 194, said potentiometer thus chosen being connected to the three pins of the current generator 140.

We immediately see that it is thus possible to define the mode of action of the clutch for each of the four functions described. In other words, the clutch return force 35 is precisely defined by each of the potentiometers 191 to 194 for the type of work chosen.

Applications in particular in physiotherapy / physiotherapy relate to the restoration, improvement, and investigation of neuro-muscular function. The device (A) can be used or not, in a pulley therapy cage; the rope 5 allows either analytical or functional use, which combines the mobility of several body segments in several planes. The programmable speed of unwinding of the rope makes it possible to execute more or less rapid, reproducible activities, depending on the objective sought. The enslavement of the resistance, to the developed tensile force, makes it possible to train the subject always to the maximum of his possibilities, regardless of the position adopted for a given speed. In addition, this enslavement cancels the painful sector which sometimes appears during the lifting of direct loads. The programmable device allows the subject to be trained specifically in cycles associating different muscular contractions: concentric slave, static and / or eccentric.

The detection of the developed force, reflected in a visualization system, provides a bio-feedback technique, useful for the subject, to control his activities. In addition, this device, by virtue of the programmable aspect of the cable rewinding efforts and of the switchable sequences, can be used for the purposes of joint traction and of osteo-articular postures.

Claims (11)

1. Apparatus for training, investigation and rehabilitation, in particular of the neuro-muscular function, comprising: - a fixed frame (1), - a working member (50) intended to be connected to the subject to be exercised (5, 55, 56), - a drive member (10,11), - a transmission device mounted between the driving member and the working member, and means for controlling the movement of the working member (50) according to predetermined parameters,
characterized in that the transmission device comprises, mounted in parallel between the motor member and the working member: - a force coupler (35), the output of which is adjustable; and - a unidirectional drive means (36), which connects the working member to the motor member when the ratio of their speeds in absolute value exceeds a predetermined threshold. 2. Apparatus according to claim 1, characterized in that the motor member comprises an electric motor (10) controlled by speed and provided with a reduction gear (11),
in that the drive input of the transmission device is an input shaft (20) driven by said reduction gear, and in that said working member consists of a rotary drum (50) on which is wound a cable (5) secured to a gripping means (55,56),
while the force coupler (35) consists of a clutch interposed between the input shaft (20) and the rotary drum (50). 3. Apparatus according to claim 2, characterized in that the clutch (35) is an electromagnetic powder clutch. 4. Apparatus according to one of claims 2 and 3, characterized in that the unidirectional drive means consists of a freewheel device (36) interposed between the input shaft and the drum. 5. Apparatus according to one of claims 1 to 4, characterized in that it comprises one or more electronic detectors with emission of positions (155) and / or of forces associated with the working member, or with the means of gripping. 6. Apparatus according to claim 5, characterized in that it comprises a display means (163) of information taken from said detector. 7. Apparatus according to one of claims 1 to 6, characterized in that it comprises a preset clock means (170) adapted to allow the display of one or more successive operating times. 8. Apparatus according to claim 7, characterized in that it comprises control means allowing the execution of exercise functions in a predetermined order, such as: slave work; static work, direct work; rest. 9. Apparatus according to one of claims 1 to 8, characterized in that it comprises a wall module (A) intended for the patient and comprising the mechanical part and the associated controls, a detection module (B), and a mobile command and control module (C), intended for an operator and the patient. 10. Apparatus according to one of claims 1 to 9, characterized in that it comprises a manual control of general interruption (104) intended for the patient. 11. Apparatus according to one of claims 1 to 10, characterized in that it comprises a VHF or FM transceiver system capable of transmitting the force information (and / or positions) of the detector connected to the subject, to the mobile command and control module C.

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